Provider Demographics
NPI:1023271707
Name:WILLIAM D. ZEICHNER A MEDICAL CORPORATION
Entity type:Organization
Organization Name:WILLIAM D. ZEICHNER A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:ZEICHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-357-1200
Mailing Address - Street 1:651 BIENVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5744
Mailing Address - Country:US
Mailing Address - Phone:318-357-1200
Mailing Address - Fax:318-352-3644
Practice Address - Street 1:651 BIENVILLE CIR
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5744
Practice Address - Country:US
Practice Address - Phone:318-357-1200
Practice Address - Fax:318-352-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2010-04-26
Deactivation Date:2008-08-08
Deactivation Code:
Reactivation Date:2010-03-11
Provider Licenses
StateLicense IDTaxonomies
LA06736R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1349712Medicaid
LA1349712Medicaid
LA5M765Medicare PIN